When I stumbled out of the gleaming new Dior spa with my gleaming new Dior face, I thanked the aesthetician for giving me the billionaire treatment. It was that good. And I would’ve bought a Bar jacket on my way out the door, but then I remembered that I’m not, in fact, a billionaire.

Billionaire skin seems to be the goal at the most exclusive facial salons and spas in the country. You won’t find framed headshots of Elon Musk and Jeff Bezos in the waiting area, because no one’s being too literal here. It’s more Kardashian, Jenner, Taylor, Rihanna billions, the kind that brings with it smoothness and radiance. It’s skin that’s tended by the highest professionals with diligence and rigor.

“Having good skin, it’s an investment,” says Sarah Akram, the esthetician who helped create the Haute Couture facial at Dior. “Billionaire skin is skin that stress doesn’t touch. It looks quietly expensive. It’s very luminous, lifted.”

To achieve this epidermal serenity requires consistency and commitment, which is not terribly different from what it takes to amass piles of money—and so much of the good life. “I mean, what do people do if they want a killer body? You can’t just go to the gym once a week and eat whatever you want,” says Akram.

“You have to be religious about this,” says Dangene, who goes by one name and masterminds the Dangene Medical Spa in New York City. Her appointments start with a head-to-toe assessment and an attack plan. It’s probably not designed for fragile egos. “I will pick them apart based on my idea of perfection,” she says. “We take what I see and their concerns, and we put them together. And then we sell them a program and put them on a schedule.” That program can cost as much as $40,000. “And what that package includes is everything”: a battery of machines—radiofrequency, microneedling, lymphatic drainage, broadband lasers, and L.E.D. light—aimed at the face, neck, chest, arms, hands, bottom, stomach, and legs. “Our job is from head to toe to make sure this human being is flawless,” she says.

Let’s say $40,000 is too rich for your blood. “You can still be an elite person and say, I only want to spend $10,000. I only want to spend $20,000,” adds Dangene. “That’s not my favorite, but I can do it.”

Still too much? There’s a $1,500 skin rejuvenation treatment that Dangene calls her bread and butter. It includes microdermabrasion, a Hydrafacial, oxygen therapy, L.E.D. lights, and a laser. Oh, and “We’ll pluck your eyebrows and check your nose and ears for hair,” says Dangene. “It’s a combination of resurfacing, cleaning you up, giving you a glow, and zhuzhing.”

This used to be a mostly female pursuit, but now men are joining in. “Because they’re calling it biohacking,” says Dangene. “Everyone does not want to die right now. It’s the craziest thing in the world. I don’t know if they’re going to live longer, but they’re spending so much time trying not to die.” For the longevity-obsessed, Dangene also offers NAD+ vitamin infusions and the like.

The polite, inoffensive steam-and-cream facial is fine for history buffs and nostalgia lovers. “That’s good if you’re 18 years old, 20 years old,” says Keren Bartov, who owns skin clinics in London and Tel Aviv. For those over 35, “you have to kill the skin,” euphemistically. Billionaires and those who want to look like them depend on serious, expensive machines overseen by a licensed technician. Given the price of this equipment, it’s no surprise that the end of a session could bring tears to your eyes in the shape of a big, beautiful bill.

In L.A., the rich person’s skin hub is Dr. Jason Diamond’s office in Beverly Hills. He’s a plastic surgeon, but he puts down the scalpel for his InstaFacial, “an all-inclusive, one-stop skin overhaul,” beloved by the Kardashians and Kardashian-adjacent. It’s a customized blend of light laser resurfacing, a swabbing of platelet-rich plasma or platelet-rich fibrin, microneedling, and a soothing collagen mask. When I asked for the all-in cost, Dr. Diamond demurred. “All I can say is, you get what you pay for.” And “it’s an investment with unlimited returns.” A friend who knows these things tells me, “Everyone complains about how expensive it is, and yet he always has a waitlist.”

Bartov presides over a shining array of skincare technology at her clinic in Notting Hill. She compares it to Luna Park with all its brightly lit attractions. There’s intense pulse light (I.P.L.) therapy, ultrasound (such as Softwave), radiofrequency machines (including the skin-tightening BTL), and low-dose microwave therapy. Bartov says her clinic is the first in London to have the latter, called the Onda Pro, which she ordered from Italy at the encouragement of—you guessed it—Kim Kardashian. “Whatever she says, I trust her,” says Bartov. “She knows everything because she tries everything.” Bartov is bringing Onda Pro to her L.A. pop-up during the Golden Globes to tend to some of the nominees and presenters—a list that may include Julia Roberts, Emma Stone, Demi Moore, Amanda Seyfried, and Teyana Taylor—who are all devotees.

She says her “very, very rich clients” can easily drop $3,000 on a single visit, employing five or six machines. Some of them make this a once-a-week habit. “They don’t care how much it costs.” When they walk out of the salon, “it’s like they had surgery without the surgery,” Bartov says.

Let’s do a little math. A weekly $3,000 session for a year—if you assume some of those weeks would be blocked off for trips to Gstaad, Costa Smerelda, or space—would bring the annual expense to at least $135,000. By comparison, a facelift looks almost thrifty.

But if you have money to burn, the only risk comes from the temptation to be overzealous. “There is such a thing as too much,” says Dr. Diamond. “We have seen patients who come here after treating their skin elsewhere far too harshly and too often with radiofrequency, ablation, etcetera, and that causes counterproductive results.”

Like a wardrobe from The Row or Loro Piana, the appeal of this well-tended skin is its subtle excellence. Dangene calls many of her ministrations “sneaky treatments. A lot of times, we’re doing things, especially for the elite, that they don’t want people to know about.”

It’s a lot of effort and expense for understatement, but that also defines the difference between nouveau-riche flash and old-money discretion. As Dr. Diamond says, “Fresh-faced is the new aspirational badge of honor.”

Linda Wells is the Editor at AIR MAIL LOOK